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Neurosurgeon: A Horror Story

2016-11-02

dr_death_chris_duntsch_mugshot

According to an article in the Dallas magazine “D”,in its November 2016 issue, Dr. Christopher Duntsch should be known as “Doctor Death.”  He is tall, has blue eyes, and before his downfall he was known for his winning manner and extreme confidence.  Here is a summary of the long and somewhat meandering article:

Dr. Duntsch received his undergraduate degree from the University of Memphis in 1994 and went to the University of Tennessee Health Science Center for medical school; he also received a doctorate summa cum laude from the  St. Jude’s Children’s Research Hospital in 2001.  He did his residency at the University of Tennessee, spending a year in surgery and five years in neurosurgery.  He was heavily involved in research and was funded by over $3 million in grants as a principal or co-principal investigator.  He started two companies based on patents for stem-cell research, one of which companies, Discgenics, is still functioning.  The two research scientists who co-founded that company, however, accused him of “taking more credit than he deserves” for their discoveries.

At a birthday party “in 2006 or 2007”, a woman stated (in a later deposition) that Dr. Duntsch ate a blotter of LSD and some prescription painkillers, chased with a quantity of cocaine.  After partying all night, it was claimed that he got up to make rounds at the hospital.

Later, a neurosurgeon who was asked to perform corrective surgery on two of Dr. Duntsch’s patients was so disturbed at the results he found that he called his residency program and was told by a Dr. Boop, chairman of the department of neurosurgery at his hospital:

Duntsch had been sent to an impaired physician program when he refused to take a drug test after an anonymous woman called to say she had seen him use cocaine, but he had been allowed to return to finish his residency. Boop also said that Duntsch spent his final year operating as an attending physician, and was not allowed to operate independently.

Dr. Duntsch tried to concentrate on research, but his handling 0f the two companies he created did not assure him of sufficient income to allow him to live in the manner to which he wished to become accustomed (there is a saying which goes: “Cocaine is G-d’s way of telling you that you have too much money.”)  Therefore, he decided to go in for clinical work.  He sought out employment opportunities, and with the help of a good recommendation from his residency, soon had several offers.

Dr. Duntsch neglected to mention in his resume that there was a small gap in his work at his residency program, which was revealed only much later.  One of his patients, Lee Passmore, had been operated on December 30, 2011, very early in the doctor’s career of botched procedures in Dallas.  Mr. Passmore was a field agent for the Collin County (Texas) Medical Examiner’s Office.   He felt that something was seriously wrong with Dr. Duntsch after he emerged from surgery worse off than when he went in.  The article describes what Mr. Passmore discovered:

[He] found a few months that were not accounted for in Duntsch’s educational history. “You don’t get to walk away from two or three years of medical training, in the middle of an internship or a residency, get to take time off and be slotted directly in the position you left in with no questions asked. Maybe that’s how they do it in Tennessee, but according to my training, that’s not how they do it here. Then it just started to all unravel.”

Dr. Duntsch took on employment at Baylor Regional Medical Center in Plano, TX as a neurosurgeon, at the rate of $600,000 a year; under his physician services agreement with Rimlawi and Won’s Minimally Invasive Spine Institute:

Base compensation was $600,000 a year for two years, beginning on June 14, 2011. Duntsch also received 40 percent of all revenue he generated beyond $800,000 each year.

Neurosurgeons make a lot of money for the hospitals at which they operate:

According to Irving-based physician recruitment firm Merritt Hawkins, a single neurosurgeon produced [for] his or her hospital an average revenue of $2.45 million in 2015.

To make a long story short, Dr. Duntsch proceeded to botch nearly every surgery to which he laid his hands, and was thrown out of one hospital after another.  A number of his patients died from preventable complications, including one who bled to death in the intensive care unit.  Others suffered complications that virtually never occur in neurosurgery, such as esophageal injuries.  While it is not unusual for neurosurgical patients to die or suffer serious complications, Dr. Duntsch’s patients virtually all had bad outcomes.  The Texas Medical Board took away his license in June 2013, after complaints that went back to early 2012.  It wasn’t until the neurosurgeons who were detailed to clean up after him went to the District Attorneys in Dallas County that he was indicted for aggravated assault during surgery in July 2015.

Dr. Duntsch clearly abused drugs and alcohol, and had serious personality problems even before his substance abuse began.  The combination of alcohol and cocaine is particularly dangerous because it produces a novel drug in the body, cocaethylene, which has a much longer half life than either of its parent drugs and tends to produce myocardial arrhythmias.  The personality defects that Dr. Duntsch had sound like a combination of narcissism, sociopathy, and drug-induced delusions.  Oddly, there was no paranoia after the use of cocaine or LSD, which suggests that Dr. Duntsch was incapable of experiencing guilt.  His complete denial of guilt and grandiose behavior suggests gross narcissism and/or sociopathy.

The article is enhanced by an interview with the aforementioned Lee Passmore, who is the only one of the patients who has sued Dr. Duntsch who has not settled his case.  All those who have settled are prevented by nondisclosure agreements, which are standard in such cases, from discussing the problems that induced them to sue.

I strongly suggest reading the article, which also describes problems with Texas laws on malpractice.  For example, it is impossible to sue hospitals in Texas for failure to supervise their physicians unless actual malice can be shown.  In addition, malpractice awards are capped at $250,000, an absurdly low figure when a single hospitalization for neurosurgery can be charged out at over three-quarters of a million dollars.  I have railed at length against some of these legal problems, not to mention the systems of recommendations which allow physicians to slip through the cracks when moving from one position to another, so I will not elaborate here.

The only shortcomings of the article are a few errors on medical details and some missing information, such as an exact timeline of what happened when in Dr. Duntsch’s erratic career.

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